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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

The natural history of Vestibular Schwannoma growth - prospective 40-year data from an unselected national cohort

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BACKGROUND: Optimal management of vestibular schwannoma(VS) is still debated and thus international consensus has not been achieved. Treatment options are observation, radiotherapy and surgery. Knowledge on the natural history of tumor growth is essential for choice of treatment modality. The aim is to present intra-/extrameatal tumor growth and management data from a prospective, unselected national cohort of patients diagnosed with VS during the period 1976-2015.

METHODS: Since 1976, all data from patients diagnosed with sporadic VS in Denmark have been referred to our national treatment center, where their data have been entered prospectively into the national database. Data on tumor localization, growth and treatment were retrieved. Growth definition:>2mm by linear measurement, in accordance with the Tokyo-2001 consensus-meeting recommendations.

RESULTS: 3637 cases of VS were diagnosed, of which 1304 patients had surgery and 21 received radiotherapy post-diagnosis. 2312 patients were observed with mean follow-up of 7.33 years, of these 434(19%; 102 intra-and 332 extrameatal tumors) changed to active treatment during the observation period due to tumor growth. Five years after diagnosis 21% of the intrameatal tumors exhibited growth during observation, whereas 37% of extrameatal tumors had grown, increasing to 25% intrameatal and 42% extrameatal after 10 years. Following growth, the intrameatal tumors were mostly observed further and the extrameatal mostly underwent surgery. Tumor growth occurred mainly within the first 5 years post-diagnosis.

CONCLUSION: This natural history study documents the growth occurrence of both intra-and extrameatal vestibular schwannomas during the first 12 years after diagnosis and should be used in patient counseling, management and treatment decision-making.

Original languageEnglish
JournalNeuro-Oncology
ISSN1522-8517
DOIs
Publication statusE-pub ahead of print - 17 Oct 2020

ID: 61229774